“On a Saturday?”
Another one of those Fridays where I mentioned that I was getting up early to drive and watch an inspirational lecture.
The songs on radio 1 that inspired me on my drive yesterday included this:
Just by Loch Lomond I also turned over the Radio 4 and heard Gove’s Weinstein comment. I almost pulled over to tweet my rage but was glad I didn’t, as the traffic then snarled up around Dumbarton and nearly made me late.
And so to Ardrossan to watch the film Resilience and hear Suzanne Zeedyk and David Cameron.
As usual, I am using my blog to record some notes and sound bites from what I heard and experienced.
If you were not able to make it, these notes may give you a flavour and encourage you to find out more. But I write and encourage you to read with the proviso that others in the room may have heard things differently.
The event started with an introduction from Suzanne Zeedyk and David Cameron.
Suzanne – her team have been working for some time to bring awareness around Adverse Childhood Experiences to the UK. The team is her, Tina Hendry, Pete on the door and Brett on the camera.
This summer their work has involved bringing the film Resilience to Scotland after it was shown down in London.
There were 25 screenings over the summer.
2500 people saw it.
By Dec this may be 10000 people.
It has had huge impact.
Vincent Felitti from the film was here in Scotland 10 years ago – but there was no revolution then. Why now?
Now we are seeing a revolution in kindness to children.
Production team in US feel that something different has happened in Scotland and want to know the strategy.
“2 crazy women with no money.”
Revolution happens because individuals want it to happen.
There is an interest in this from the govt; there is an ace website
ACES feature in the govt Nation with Ambition document- pages 71 and 73.
Lots of our communities have adults and children who have been damaged by trauma.
But there are still situations where schools make it worse for children
and some social work systems do.
How do we have more awareness and kindness?
“Only doing this cause he wanted to be in Ardrossan on a Saturday and see a movie.”
We have raised awareness but not made a difference.
Still the same for most of us.
Danger is that SG focus is now raising attainment and social mobility – these are the new “initiatives” that we will try and paint on the wall before we properly embed GIRFEC and CfE and trauma-informed practice and allow the paint of those important systems to dry.
Painting on wet paint,
Getting 5 highers and going to uni is not all there is. Leaving Ayrshire is not all there is.
Need to get it right for ALL kids.
Need to take control and do what we can where we are.
David wants us to walk in in the morning and say “that’s brilliant” and mean it.
“Campaign for brilliant”
Us being here in a Saturday will change this.
Suzanne agrees- needs to be grassroots.
Investment in the denial of the impact of trauma is so high.
We need to address people not wanting to talk about it.
We then watched the amazing, moving, life-affirming film Resilience. YOU NEED TO SEE THIS FILM IF YOU HAVE NOT AND YOU CARE ABOUT CHILDREN. (I’m not shouting but I am stating this emphatically.)
The film features a number of child specialists, paediatricians and medical professionals from the USA who have, over the last 20 years or so, been working in a way that is attachment and trauma informed and recognises the impact of adverse childhood experiences on both mental and physical health.
Robert Anda MD talks about the fact that this information needs to get to everyone not just the smart people. Vincent Felitti explains how when he first started talking about trauma informed practice and adverse childhood experiences he was called crazy by his colleagues.
The film shows how the two men had initially been working on different projects in different parts of the countries before they came together to realise that their conclusions were parallel.
Some of the work came from discoveries in an obesity clinic where the prevalence of childhood sexual abuse amongst those with obesity was striking.
Both men had worked on small studies on the impact of adversity childhood experiences but realised that the study needed to go bigger.
A study was then carried out between 1995 and 1997 amongst 17,000 middle-class adults. They completed a survey on their health but also answered on questions around separation, divorce, parenting, aggression and abuse. Out of this there then came a list of 10 adverse childhood experiences around which the research continued:
Prior to your 18th birthday:
1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt? No___If Yes, enter 1 __
2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured No___If Yes, enter 1 __
3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you No___If Yes, enter 1 __
4. Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other No___If Yes, enter 1 __
5. Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it No___If Yes, enter 1 __
6. Were your parents ever separated or divorced No___If Yes, enter 1 __
7. Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife No___If Yes, enter 1 __
8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs No___If Yes, enter 1 __
9. Was a household member depressed or mentally ill, or did a household member attempt suicide? No___If Yes, enter 1 __
10. Did a household member go to prison? No___If Yes, enter 1 __
The results of the surveys were shocking:
28% of those surveyed had suffered physical abuse, 27% had experienced substance abuse, 13% had witnessed her mother being hurt, and one in five had experienced sexual abuse.
And the direct correlation between the ACES experienced and physical symptoms such as heart disease, strokes, addiction, depression, suicide and even cancer was striking.
The findings caused a huge amount of shock as previously researchers had had no idea about how much abuse there are is in our communities. The conclusions also found that with ACE score of 4 out of 10, participants were three times as likely to have experienced depression. Initially Robert Anda was faced with disbelief and was told he must have done something wrong in his investigations. However they went back through the research and the statistics and realised that there was nothing wrong. Anda stated “this is real but no one wants to know about it.”
10 years after the initial case study Dr Nadine Burke Harris was working in clinics with children in San Francisco. She became aware in the work that she was doing that adverse childhood experiences were absolutely crucial to child development, child health and adult health. She explains that she had never trained in any of this during medical school but it was obvious to her in her practice about the impact of ACES on child and later adult physical health. She discovered that in poor communities the average life expectancy was 67 as opposed to it being 78 in more wealthy communities. The key factors in the poorer communities that led to increased heart disease, obesity, depression, suicide, cancers, strokes and early death were:
mental health issues, violence, the death of friends and drug and substance abuse.
In 2007 she found out about the ACES study and found that it gave her total validation of what she was saying in the community she was working.
She realised first and foremost that one of the key things in tackling the impact of adverse childhood experiences is to be honest about the situation: children need to be told that hearing gunshots and seeing your friends incarcerated on a daily basis has an impact on your life and your feelings And that these things are not okay. She explained that in her practice lots of parents were coming and asking for help with ADHD and problem behaviours. However when she looked she realised that the behaviours were not caused by ADHD but rather by trauma. Symptoms such as impulse control and hyper activity can be just as much of a symptom of trauma as ADHD. She explained that there is a real danger in giving a traumatised child a stimulant, as it will not help. She went on to explain the power of brain scans in this work as they show quite clearly the neurological changes that are caused when children experience trauma.
With a score of four or more ACES of child is 32 times likely to have behavioural problems. Which ACES a child has experienced is irrelevant.
Vincent Felitti goes on to say “we divide the world of mental health and physical health but the body does not do that.”
ACE screening has now become an important part of child health care in many parts of America. There was acknowledgement that it is not easy work to do as it requires people to be open and honest about to traumatic events that have happened to them and their children.
The film also talks about the concept of toxic stress. There is an explanation of the fact that some stress in our lives is necessary, for example we need a bit of stress when crossing the road so that we act quickly and alertly. However exposure to early trauma effect affects the structure of children’s brains and means that they live in a state of high undifferentiated stress at all times. which leads to poor mental and physical ill-health.
Dr Burke Harris goes on to say that you can give people things to mask symptoms for example if someone has a cough you can give them cough serum which will suppress the cough but may also mask tuberculosis or cancer while the disease process continues to fester. The same is true with adverse childhood experiences.
Jack P Shonkoff MD speaks about the fact that children who are born with a poor start in life are not doomed. The science shows otherwise. He speaks about the term toxic stress stress which is the chronic activation a stress reaction with no support to manage that stress.
He talked about the fact in school we often say that children with toxic stress should just suck it up and be like the successful kids. He points out however that the baby can’t just pull itself up by its bootee straps and suck it up. We would never say to a cancer patient that they need to suck it up and we should not do the same with children who have experienced trauma.
Resilience (the ability to survive and thrive in spite of trauma) is learnt but you cannot learn it if you are living in a culture of fear. A child cannot learn conflict resolution if his parents are constantly fighting.
A child cannot plan for the future if she lives in a culture of fear where the future seems frightening. A child cannot learn to delay gratification if she is constantly mixing with friends who do drugs. The key to learning resilience is the presence of stable and caring adults. In order for adults to be caring and stable they need to acknowledge their own early experiences and transform their own lives. Adults need to build their own capabilities in planning, monitoring, and impulse control. This is about more than just reading to kids.
It is absolutely crucial that we treat the family rather than just the child and help the family to learn successful strategies. And there are lots of really good programs out there. There is a need to break the cycle of adverse childhood experiences and the impact of trauma. The importance of visiting families in their own homes cannot be underestimated. It makes the families feel as if they matter. We all need to consider the impact of our early experiences if we work with children. There is always a reason why we do what we do in the here and now.
The question has to be why are we waiting. Adults often do not recognise that kids have stressed because they do not seem as important or big as adults stresses like having to pay the mortgage or support the family. But this work shows that small stresses matter and do have impact on children. If children act out there is a reason but often children do not have the skills or vocabulary to manage the stress.
The film shows an incredible primary teacher at work in a school using the legend of Miss Kendra. This is a story which enables children to talk about the adverse childhood experiences that they may be experiencing. Miss Kendra’s list is a list of affirmations that children repeat on a daily basis so that they are able to use the right vocabulary when they need to. They repeat phrases such as “no child should be punched or kicked” “no child should be touched on their private parts”. Lots of children think what they are going through is normal but the mantra helps them to understand that it is not. The children regularly write a letter to Miss Kendra where they can talk about things that they may be experiencing. These are then answered by a drama therapist. Studies have found that this type of work is most effective when done with pupils in their third year of primary school. Naming the scary thing helps us feel safer. The teachers then spend less time managing scary feelings and more time on teaching.
The film also looks at schools which adopt a so-called no excuses policy. This takes the approach that teachers say “yes you may be being beaten but it is not an excuse to do badly at school”. It is based on an idea that we are trying to ensure the same standards of achievement for all children and be aspirational…But it will not work unless we deal with the causes of trauma as well as acknowledging them. It is not enough to say “yes I understand your situation”; we also have to address the situation. The only effective approach is not to use things as an excuse but to deal with them. To talk, to act and to help children develop resilience.
Toxic stress is a neurological issue,
it is an endochrinal problem, it is a problem of chronic inflammation in the brain and it is a problem that we can address and deal with. We need universal screening for ACES. We need to reduce experience of adversity. As Nadine Burke Harris says, if a child has lead poisoning we reduce the amount of lead. If a child is experiencing trauma, we need to reduce the amount of trauma.
We need to ensure that there is strong parental buffering and we need to help parents to find their natural strengths as parents and build on them. All parents want the best for their children. The answers include mindfulness, meditation, therapy, good nutrition, exercise, sleep, and education. Parents need to understand all of this.
It’s crucial that those involved with the children are trauma informed. We should not talk about what is wrong with children. We should talk about what has happened to children.
Getting adults who work with children to do a screening is very important.
The highest ACE scores ever were in an audience of psychotherapists!
We are the sum of everything that we have lived.
In 2000, Laura Porter, Senior Director of The Learning Institute at the Foundation for Healthy Generations, invited Robert Anda to her community in Washington. She was a very impatient person and wanted to change things straight away. She worked for 10 years on a trauma informed model. Policies and practices were all changed and it had a huge impact on youth crime suicide incarceration and health. And it also saved a huge amount of money on health care.
“You can lead a horse to water and not make him drink but you can make him thirsty”.
As a community of individuals we can change the world.
Following the film, Suzanne and David spoke further and facilitated discussion around how educational leaders can bring about change in their settings to allow the culture to change.
Suzanne shared examples of schools and groups who have been successful in bringing about changes.
If we close the attachment gap we will change the attainment gap.
Voices of Chris Kilkenny and Jaz Ampaw Farr are very important.
Don’t let ourselves be defined by our worst moment.
The alternative to hope is despair.
We need action.
We need to focus on and develop what we do well. We need family care not child care.
There is a new breed of school leaders.
The more we label things, the more we get away from connection
We have a curriculum that allows us to do better, even in secondary.
We need to be confident.
Use the breakable plates graph:
Put the things you do on post it’s. Then put them on the graph. See what you can do less of because it does not have impact.
Lots of the things we do in secondary schools are about habit and not structures.
How people make you feel make the difference.
Often when we need to change practice we do not ask the right questions
Eg exam analysis-
We look at what was rubbish for kids last year, try and apply it to different kids this year… and wonder when people get annoyed when we focus on the negative.
We need to give children opportunities to achieve success. Look for the gifts in the child – Amjad Ali.
Give them open tasks and allow them to surprise us.
Allow kids to rehearse and redraft- failure is only temporary
What conversations do we need to have?
We need to train early years staff and pay them better. We need training on brain science absolutely attachment.
Children 1st has a kitbag – like Miss Kendra’s list. It is very good. We can get them to bring it to us.
Those on Suzanne’s list are not experts but they gave it a shot.
We should do mindfulness and yoga every day but we don’t and this does harm.
The impact of teacher behaviour on a pupil and the ability of a teacher to cause trauma cannot be under-estimated.
Voices from the floor spoke of the following:
The need to be human
The need to value families
The importance of relationships and connection.
And although I was nervous and incredibly stressed and feeling like an imposter and hardly able to do it, I took the microphone and heard my own voice. And it said:
– Too many in secondary schools still want discipline, compliance and children who “know how to behave”.
– My blog is full of thoughts on how we can change things and reflections on why change is hard.
– We cannot allow the fact that the revolution has taken a while to stop us keeping on with this work.
– Some teachers may feel that they are not qualified to do this work as they are not therapists But this is not about therapy. It is about life. It is about us adults being honest about the ups and down of life but showing up and being role models. It is about the assembly I gave yesterday: https://lenabellina.wordpress.com/2017/10/28/fairness/
– And no matter how jaded we feel, we can’t give up.
Thanks Suzanne. You are astonishing.
Thanks David. You are amazing. And your commitment to yoga is exemplary.
Thanks to the makers of Resilience.
Thanks to all those in the room who get it and showed that by being there.
We need to keep going.